V3-05: Inflatable Penile Prosthesis Removal and Replacement with Corporal Reconstruction

Video

Introductions and Objectives
The use of Gortex(R) as a replacement material in genitourinary reconstruction has been described previously in the urologic literature. In this video, we demonstrate the novel technique of corporeal reconstruction using a Gortex(R) graft at the time of inflatable penile prosthesis (IPP) in a challenging surgical scenario - a patient with marked corporal fibrosis and scarring after multiple previous removal and replacement procedures.

Methods
We are presenting a case demonstration of successful Gortex graft placement for corporeal replacement in a patient with two previous IPP placements with subsequent cylinder removals leading to a markedly fibrotic, narrow caliber corpora.

Results
The patient was 53 years old Caucasian male with organic erectile dysfunction. He had a body mass index of 24.9 kg/m2. He had developed a narrow, fibrotic right corpora secondary to multiple previous surgical procedures with his right sided cylinder removed more than a year previously without replacement. His right corpora was incised and measured only 15mm in width. A Gortex(R) graft of 7.0 x 2.5cm in size was fashioned to lay over the defect with the cylinder inflated. This was sewn into place with 3-0 Prolene, creating a water-tight seal. Total operative time was 119 minutes. Estimated blood loss was minimal. No perioperative complications were noted. The patient was seen 4 weeks post-operatively for routine follow-up without complications.

Conclusions
This case provides initial evidence of safety and feasibility of the use of Gortex(R) graft material for corporal replacement in challenging surgical scenarios such as IPP replacement in patients with marked corporal narrowing and fibrosis.

Funding: None